State of New Jersey

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State of New Jersey Emergency Medical Dispatch
Guidecards
  Approved by the State of New Jersey
Department of Health and Senior Services Office
of Emergency Medical Services
Adopted by the State of New Jersey Office of
Information Technology Office of Emergency
Telecommunications Services January 2012
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GUIDECARD INDEX
Traumatic Incident Types ANIMAL
BITES ASSAULT/DOMESTIC VIOLENCE / SEXUAL
ASSAULT BLEEDING / LACERATION BURNS EYE PROBLEMS
/ INJURIES FALL VICTIM HEAT / COLD
EXPOSURE INDUSTRIAL ACCIDENT STABBING / GUNSHOT
VICTIM / ASSAULT TRAUMATIC INJURY VEHICULAR
RELATED INJURIES
Traumatic Incident Types
Time / Life-Critical Events CO POISONING /
INHALATION / HAZMAT CARDIAC ARREST / DOA - ADULT
CPR INSTRUCTIONS - CHILD CPR INSTRUCTIONS -
INFANT CPR INSTRUCTIONS CHOKING - ADULT
CHOKING INSTRUCTIONS - CHILD CHOKING
INSTRUCTIONS - INFANT CHOKING INSTRUCTIONS DROWNI
NG (POSSIBLE) ELECTROCUTION PREGNANCY /
CHILDBIRTH - CHILDBIRTH INSTRUCTIONS UNCONSCIOUS
/ FAINTING - UNCONSCIOUS AIRWAY CONTROL
(NON-TRAUMA) INSTRUCTIONS - UNCONSCIOUS AIRWAY
CONTROL (TRAUMA) INSTRUCTIONS
Time / Life-Critical Events
Medical Chief Complaint Types
Medical Chief Complaint Types ABDOMINAL
PAINS ALLERGIES / STINGS BACK PAIN BREATHING
PROBLEMS CHEST PAIN / HEART PROBLEMS DIABETIC
PROBLEMS HEADACHE OD/POISONINGS /
INGESTIONS PSYCHIATRIC / BEHAVIORAL
PROBLEMS SEIZURES / CONVULSIONS SICK
PERSON STROKE / CVA UNKNOWN / PERSON DOWN
Miscellaneous AIR MEDICAL DISPATCH
PROCEDURE AIRCRAFT / TERRORISM HAZMAT VEHICLE IN
WATER
Miscellaneous
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ALL CALLERS INTERROGATION

• 1 Where is your emergency? (Address or
  Location)
• What is the number you are calling from?
• What is the emergency?
• What is your name?
• Determine age and sex of patient

6. Is the patient conscious? (Able to talk)
YES
Dispatch ALS BLS
NO
7. Is the patient breathing NORMALLY?
7. Is the patient breathing NORMALLY?
YES
NO / UNCERTAIN
NO
UNCERTAIN
YES
Determine chief complaint and turn to appropriate
card.
Go to CPR Instructions for age group
Go to
Go to
Go to
BREATHING PROBLEMS
UNCONSCIOUS/ FAINTING
CARDIAC ARREST/DOA
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ANIMAL BITES
State of New Jersey EMD Guidecards Version 01/12
KEYQUESTIONS
Is the patient bleeding? IF YES, Can it be
controlled with pressure? How long ago did they
receive the bite?
Is the animal contained? What type of animal
bit the patient? Is the patient short of breath
or does it hurt to breathe? What part of the
body was bitten?
SIMULTANEOUS ALS/BLS
BLS
DISPATCH
DISPATCH
Unconscious/not breathing normally. Decreased
level of consciousness. Uncontrolled bleeding,
after attempts to control. Serious neck or face
bites from animal attacks. Bites from known
poisonous animals.
Controlled bleeding. Swelling at bite site. Bite
below neck, non-poisonous.
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ANIMAL BITES Pre-Arrival Instructions
Contain the animal, if possible. Lock away any
pets. If severe bleeding go to If little or no
bleeding, irrigate human and animal bites with
copious amounts of water. Keep patient calm and
still.
For snake bites Apply direct pressure to the
wound. Do not elevate extremity. Do not use
ice. Do not attempt to remove venom. For
jellyfish stings Wash with vinegar or baking
soda. If the patients condition changes, call me
back.
BLEEDING/LACERATION Pre-Arrival Instructions
Prompts
Has law enforcement been notified? Has Animal
Control been notified?
FOLLOW AIR MEDICAL DISPATCH GUIDELINES
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BURNS
State of New Jersey EMD Guidecards Version 01/12
How was the patient burned? THERMAL Is
anything on the patient still burning? If YES,
Stop the burning. Place burned area in cool
water (not ice), if convenient ELECTRICAL Go
to
KEYQUESTIONS
CHEMICAL What chemical caused the burn?
Where is the
patient burned?
IF HEAD OR FACE Is the patient short of
breath, coughing or does it hurt to breathe? Is
the patient having difficulty swallowing? Are
there burns around their mouth and nose? Are
there any other injuries?
ELECTROCUTION
SIMULTANEOUS ALS/BLS
BLS
DISPATCH
DISPATCH
Decreased level of consciousness. Burns to
airway, nose, mouth. Hoarseness, difficulty
talking or swallowing. Burns over 20 of body
surface. Electrical Burns/electrocution from 220
volts or greater power lines/panel boxes. 2nd
3rd degree burns (partial or full thickness) to
Palms (hands) Soles
(feet) Groin
Less than 20 body surface burned. Spilled hot
liquids. Chemical burns to eyes. Small burn from
match, cigarette. Household electric
shock. Battery explosion. Freezer burns.
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ABDOMINAL PAIN
State of New Jersey EMD Guidecards Version 01/12
KEYQUESTIONS
Is the pain due to an injury to the
patient? How does the patient feel sitting
up? Is the pain above or below the belly
button? If the patient is female between 12-50
years Could she be pregnant? Has there
been vaginal bleeding? If yes, How much?
Has she said she felt dizzy?
Has the patient vomited? If yes, What does
the vomit look like? Are the patient's bowel
movements black and tarry? Is the patient
wearing a Medic Alert tag? If yes, What does
it say? Does the patient have Addisons
Disease, recent trauma or any other medical or
surgical history?
SIMULTANEOUS ALS/BLS
BLS
DISPATCH
DISPATCH
Vomiting blood (red/dark red) or coffee
ground-like substance. Pain with prior history
of Addisons disease or adrenal insufficiency. Blac
k tarry stool. Lower abdominal pain, woman 12-50
years (if associated with dizziness or fainting
or heavy vaginal bleeding). Upper abdominal pain
with prior history of heart problem. Abdominal
pain with fainting or near fainting, patient
over 50 yrs. Fainting/near fainting when
sitting. (hypotension)
Pain with vomiting. Flank pain (Kidney
stone). Abdominal (non-traumatic). Pain
unspecified.
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ADDISONS DISEASE Chronic Adrenal
Insufficiency Hypocortisolism Hypoadrenalism
Thomas Addison first described the clinical
presentation of primary adrenocortical
insufficiency (Addison disease) in 1855 in his
classic paper, On the Constitutional and Local
Effects of Disease of the Supra-Renal
Capsules.1 Addison's disease is a disorder
that occurs when your body produces insufficient
amounts of certain hormones produced by your
adrenal glands. In Addison's disease, your
adrenal glands produce too little cortisol and
often insufficient levels of aldosterone as well.
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ADDISONS DISEASE Chronic Adrenal
Insufficiency Hypocortisolism Hypoadrenalism
Addison's disease symptoms usually develop
slowly, often over several months, and may
include Muscle weakness and fatigue Weight
loss and decreased appetite Darkening of your
skin (hyperpigmentation) Low blood pressure, even
fainting Salt craving Low blood sugar
(hypoglycemia) Nausea, diarrhea or
vomiting Muscle or joint pains Irritability Depres
sion
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ADDISONS DISEASE Chronic Adrenal
Insufficiency Hypocortisolism Hypoadrenalism

• Acute adrenal failure (addisonian crisis)
  Sometimes the signs and symptoms of Addison's
  disease may appear suddenly. In acute adrenal
  failure (addisonian crisis), the signs and
  symptoms may also include
• Abnormal heart rhythms
• Pain in your lower back, abdomen or legs
• Severe vomiting and diarrhea, leading to
  dehydration
• Low blood pressure
• Loss of consciousness
• High potassium (hyperkalemia)
• Standard therapy involves intravenous injections
  of glucocorticoids and large volumes of
  intravenous saline solution with dextrose
  (glucose), a type of sugar. This treatment
  usually brings rapid improvement.

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ADDISONS DISEASE Chronic Adrenal
Insufficiency Hypocortisolism Hypoadrenalism
Caution must be exercised when the person with
Addison's disease becomes unwell with infection,
has surgery or other trauma, or becomes pregnant.
In such instances, their replacement
glucocorticoids, whether in the form of
hydrocortisone, prednisone, prednisolone, or
other equivalent, often need to be increased.
Inability to take oral medication may prompt
hospital attendance to receive steroids
intravenously. A person with adrenal
insufficiency should always carry identification
stating their condition in case of an emergency.
The card should alert emergency personnel about
the need to inject 100 mg of cortisol if its
bearer is found severely injured or unable to
answer questions. Immediate medical attention is
needed when severe infections, vomiting, or
diarrhea occur, as these conditions can
precipitate an Addisonian crisis.
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ABDOMINAL PAIN Pre-Arrival Instructions
Nothing to eat or drink. Monitor for
shock Skin cool and clammy or mottled, rapid
shallow breathing, fatigue, altered mental state,
dilated pupils. Gather patient medications, if
any. If the patients condition changes, call me
back.

• Symptoms of an Addison or adrenal crisis
  include
• Severe vomiting and diarrhea
• Dehydration
• Low blood pressure
• Loss of consciousness
• If not treated, an Addison crisis can be fatal.

Prompts
Short Report
AgeSexSpecific locationChief
complaintPertinent related symptomsMedical/Surgi
cal history, if anyOther agencies respondingAny
dangers to responding units
If unconscious, go to UNCONSCIOUS/ BREATHING
NORMALLY AIRWAY CONTROL. If unconscious, NOT
breathing normally, go to CPR for appropriate
age group.
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CHEST PAIN/HEART PROBLEMS
State of New Jersey EMD Guidecards Version 01/12
Where in the chest is the pain
located? Does the patient feel pain anywhere
else? If so, where? How long has the pain been
present? Is the patient sweating
profusely? Is the patient nauseated or
vomiting? Is the patient weak, dizzy, or
faint?
KEYQUESTIONS
How does the patient act when he/she sits up?
Does the pain change when the person breathes or
moves? Has the patient ever had a heart
problem, heart surgery, a device to help their
heart work or a previous heart attack? Is the
patient experiencing rapid heart rate with chest
pain?
SIMULTANEOUS ALS/BLS
BLS
DISPATCH
DISPATCH
Decreased level of consciousness. Patient
complaining of chest pain with any of the
critical symptons Short of breath,nausea,
diaphoretic (sweating profusely), rapid heart
rate, syncope (weak, dizzy or faint) or with
cocaine/crack (drug) use.
Patients under 35, without critical symptoms
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CHEST PAIN/HEART PROBLEMS Pre-Arrival
Instructions
Does the patient have nitroglycerin? If yes
Has the patient taken one? if not taken, Take
as the physician has directed (patient should be
seated). If the patient does not have
nitroglycerin Can the patient take aspirin? If
yes Have they had any bleeding from mouth or
rectum? If no bleeding, advise caller to assist
patient to take 1 full size (325mg) adult aspirin
or 4 low dose (81mg) tablets. Have the patient
chew the pills before swallowing.
Have the patient sit or lie down, whichever is
more comfortable. Keep patient calm. Loosen any
tight clothing. Gather patient medications, if
any. If the patients condition changes, call me
back.
Prompts
If unconscious, go to UNCONSCIOUS/BREATHING
NORMALLY AIRWAY CONTROL. If unconscious, NOT
breathing normally, go to CPR for appropriate age
group. If the patient has a ventricular assist
device, (may be called a VAD, heart pump, RVAD,
LVAD, BVAD, or LVAS) do not perform chest
compressions. If patient has a pacemaker or
internal defibrillator CPR can be performed if
needed.
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A Ventricular assist device, or VAD, is a
mechanical circulatory device that is used to
partially or completely replace the function of a
failing heart. Some VADs are intended for short
term use, typically for patients recovering from
heart attacks or heart surgery, while others are
intended for long term use (months to years and
in some cases for life), typically for patients
suffering from congestive heart failure. VADs
need to be clearly distinguished from artificial
hearts, which are designed to completely take
over cardiac function and generally require the
removal of the patient's heart.
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VADs are designed to assist either the right
(RVAD) or left (LVAD) ventricle, or both at once
(BiVAD). Which of these types is used depends
primarily on the underlying heart disease and the
pulmonary arterial resistance that determines the
load on the right ventricle.
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Device Manufacturer Type Approval Status as of July 2009
Novacor World Heart Pulsatile. Was approved for use in North America, European Union and Japan. Now defunct and no longer supported by the manufacturer.
HeartMate XVE Thoratec Pulsatile. FDA approval for BTT in 2001 and DT in 2003. CE Mark Authorized. Rarely used anymore due to reliability concerns.
HeartMate II Thoratec Rotor driven continuous axial flow, ball and cup bearings. Approved for use in North America and EU. CE Mark Authorized. FDA approval for BTT in April 2008. Recently approved by FDA in the US for Destination Therapy (as at January 2010).
HeartMate III Thoratec Continuous flow driven by a magnetically suspended axial flow rotor. Clinical trials yet to start, uncertain future.
Incor Berlin Heart Continuous flow driven by a magnetically suspended axial flow rotor. Approved for use in European Union. Used on humanitarian approvals on case by case basis in the US. Entered clinical trials in the US in 2009.
Excor Pediatric Berlin Heart External membrane pump device designed for children. Approved for use in European Union. FDA granted Humanitarian Device Exemption for US in December 2011.
Jarvik 2000 Jarvik Heart Continuous flow, axial rotor supported by ceramic bearings. Currently used in the United States as a bridge to heart transplant under an FDA-approved clinical investigation. In Europe, the Jarvik 2000 has earned CE Mark certification for both bridge-to-transplant and lifetime use. Child version currently being developed.
MicroMed DeBakey VAD MicroMed Continuous flow driven by axial rotor supported by ceramic bearings. Approved for use in the European Union. The child version is approved by the FDA for use in children in USA. Undergoing clinical trials in USA for FDA approval.
VentrAssistdead link Ventracor33 Continuous flow driven by a hydrodynamically suspended centrifugal rotor. Approved for use in European Union and Australia. Company declared bankrupt while clinical trials for FDA approval were underway in 2009. Company now dissolved and intellectual property sold to Thoratec.
MTIHeartLVAD MiTiHeart Corporation Continuous flow driven by a magnetically suspended centrifugal rotor. Yet to start clinical trials.
C-Pulse Sunshine Heart Pulsatile, driven by an inflatable cuff around the aorta. Currently in clinical trials in the US and Australia.
HVAD HeartWare Miniature "third generation" device with centrifugal blood path and hydromagnetically suspended rotor that may be placed in the pericardial space. Obtained CE Mark for distribution in Europe, January 2009. Initiated US BTT trial in October 2008 (completed February 2010) and US DT trial in August 2010.
DuraHeart Terumo Magnetically levitated centrifugal pump. CE approved, US FDA trials underway as at January 2010.
Thoratec PVAD (Paracorporeal Ventricular Assist Device) Thoratec Pulsatile system includes three major components Blood pump, cannulae and pneumatic driver (dual drive console or portable VAD driver). CE Mark Authorized. Received FDA approval for BTT in 1995 and for post-cardiotomy recovery (open heart surgery) in 1998.
IVAD - Implantable Ventricular Assist Device Thoratec Pulsatile system includes three major components Blood pump, cannulae and pneumatic driver (dual drive console or portable VAD driver). CE Mark Authorized. Received FDA approval for BTT in 2004. Authorized only for internal implant, not for paracorporeal implant due to reliability issues.
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DO NOT PERFORM CPR IF PATIENT HAS A Ventricular
Assist Device While the patient may appear
unconscious and not seem to have a pulse the pump
is still circulating blood and can keeping the
patient in a viable condition. Pressure on the
chest may cause the tubing to detach from the
heart or damage the device itself causing sever
internal blood loss.
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CARDIAC ARREST / DOA
State of New Jersey EMD Guidecards Version 01/12
If unsure about consciousness Does the
patient respond to you? Talk to you? Answer
questions? Hear you? Does the patient move?
Flinch? Move arms or legs? Are the pupils fixed
and dilated?
KEYQUESTIONS
If unsure about breathing Look and see if the
chest rises and falls. Listen for the sound,
frequency and description of breaths.Agonal
respirations are often reported as gasping,
snoring, or gurgling barely breathing
moaning weak or heavy occasional
SIMULTANEOUS ALS/BLS
BLS
DISPATCH
DISPATCH
Unresponsive Unconscious/not breathing adequately
(Agonal) or not at all. Possible DOA of unknown
origin Delayed response
FOLLOW LOCAL PROTOCOL CONFIRMED
HOSPICE EXPECTED DEATH
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CARDIAC ARREST / DOA Pre-Arrival Instructions
Go to CPR card for the appropriate age
group. Age 8 years and ABOVE Age 1 year to 8
years Age 0 to 1 year
.
ADULT CPR INSTRUCTIONS
CHILD CPR INSTRUCTIONS
INFANT CPR INSTRUCTIONS
Prompts
Short Report
Agonal respirations are ineffective breaths which
occur after Cardiac Arrest. Indicate the need
for CPR. Brief generalized seizures may be an
indication of cardiac arrest.
AgeSexSpecific locationChief
complaintPertinent related symptomsMedical/Surgi
cal history, if anyOther agencies respondingAny
dangers to responding units
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ADULT CPR INSTRUCTIONS
ADULT CPR INSTRUCTIONS
Begin CPR on the patient now. Ill stay on the
line if you need me until help arrives.
Do you have a cordless phone? Is there a phone
that may be closer to the patient? Can someone
there relay my instructions to you? If not
Ill give you the instructions, then return to
the phone. If Im not here, stay on the line.
OK
Listen carefully. Ill tell you what to do. Get
the patient FLAT on their back, on the floor.
Is there anyone there that can help you gently
roll or slide the patient to the floor? If not
Can you get help and return to the phone?
OK
CANT
OK
NO HELP / CANT
Begin, make your best attempt.
ADULT CPR INSTRUCTIONS - Page 1 of 4 (01/12)
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• DO NOT OPERATE AED IN/OR AROUND
• Water, snow or ice.
• Bathtubs, pools or Jacuzzis.
• Metal, street ventilation gates.
• Hazardous materials.
• Any type of conductive medium.

? CHOKING ADULT ENTRY POINT
Is there an automatic defibrillator in the area?"
NO
YES
AED Instructions If alone, have caller obtain
AED and return to patient. Open the machine and
turn it on. Follow the voice prompts and
instructions from the machine. Use large size
pads on adults. . If others are present have
someone obtain AED while caller begins CPR. When
AED arrives instruct person to set up AED for use
without interrupting CPR in progress. Use large
size pads on adults. Advise when AED is ready to
use. Stop CPR and turn on the AED. Follow the
voice prompts and instructions from the machine.
.
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CPR Instructions Kneel at the patients side
and bare the chest, do you see any tubes or wires
coming out of the chest or abdomen?
If YES, STOP- DO NOT START CPR, Go to SPECIAL
CONSIDERATIONS on Page 4 If NO Put the HEEL
of your HAND on the CENTER of their CHEST,
between the nipples Put your OTHER HAND ON TOP
of THAT hand. PUSH DOWN on the HEELS of your
hands, at least 2 inches. Do it 30 times, PUSH
HARD AND FAST. If not performing MOUTH TO MOUTH
breathing, ADVISE caller to continue to PUMP the
CHEST until help arrives or until the patient
shows any signs of movement or breathing. If
doing mouth to mouth Then, PINCH the NOSE SHUT
and LIFT the CHIN so the head BENDS
BACK. Completely cover their mouth with your
mouth Give TWO BREATHS each lasting 1 second,
then PUMP the CHEST 30 times. KEEP DOING IT
UNTIL HELP CAN TAKE OVER. If an AED becomes
available see AED Instructions on Page 2
If there is more than one person present that is
willing to perform CPR have them switch with the
person doing CPR every 2 minutes
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SPECIAL CONSIDERATIONS
Patient has a Stoma Breathing Instructions
Keep the patients head STRAIGHT. COMPLETELY
COVER the STOMA with your mouth. COVER the
patients MOUTH and NOSE with your hand. GIVE
TWO BREATHS OF AIR inflating the patients
LUNGS. Make sure the CHEST GENTLY RISES.
Patient has tubes or wires protruding from chest
or abdomen Does the patient have a ventricular
assist device? (May be called a VAD, heart pump,
RVAD, LVAD, BVAD, or LVAS.) If YES, Do not
perform chest compressions. If patients has a
pacemaker or internal defibrillator return to CPR
instructions.
Patient has vomited Turn his/her head to the
side. Sweep it all out with your fingers
before doing mouth-to-mouth. Resume CPR.
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CHOKING ADULT INSTRUCTIONS
START
PROMPT If the event is NOT WITNESSED and the
patient is UNCONSCIOUS Go to CPR ADULT.
Is the patient able to TALK or COUGH?
If mild obstruction is present and the victim is
coughing forcefully, do not interfere with the
patients spontaneous coughing and breathing
efforts. Attempt to relieve the obstruction only
if the cough becomes silent, respiratory
difficulty increases or the victim becomes
unresponsive.
NO
YES
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Conscious Patient Instructions Listen
carefully. Ill tell you what to do next. Stand
BEHIND the patient. Wrap your arms AROUND the
waist. Make a fist with ONE hand and place the
thumb side against the STOMACH, in the MIDDLE,
slightly above the NAVEL. GRASP your fist with
the other hand. PRESS into the stomach with
QUICK, UPWARD thrusts. Repeat thrusts until the
item is expelled. If unable to reach around
waist or if patient is in late stage of
pregnancy, reach under the arms and place hands
on center of chest. GRASP your fist with the
other hand. PRESS into chest with QUICK thrusts
until item is expelled. If the patient becomes
unconscious, come back to the phone.
Is the patient CONSCIOUS?
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Unconscious Patient Instructions Compressions
Only Get the patient FLAT on their back on the
floor. Kneel at the patients side and bare the
chest, do you see any tubes or wires coming out
of the chest or abdomen? If YES, STOP- DO NOT
START CPR, Go to ADULT CPR SPECIAL
CONSIDERATIONS If NO Put the HEEL of your HAND
on the CENTER of their CHEST between the
nipples. Put your OTHER HAND ON TOP of THAT
hand. PUSH DOWN on the HEELS of your hands, at
least 2 inches. Do it 30 times, PUSH HARD AND
FAST. Then, PINCH the NOSE SHUT and LIFT the
CHIN so the head BENDS BACK. LOOK IN THE MOUTH
FOR OBJECT. If seen, remove it. KEEP DOING IT
UNTIL HELP CAN TAKE OVER or the patient starts
breathing. GO TO If an AED becomes available
go to
If there is more than one person present that is
willing to perform CPR have them switch with the
person doing CPR every 2 minutes
UNCONCIOUS AIRWAY CONTROL
ENTRY POINT FROM ADULT CHOKING
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Unconscious Patient Instructions With
Ventilations Get the patient FLAT on their back
on the floor. Kneel at the patients side and
bare the chest, do you see any tubes or wires
coming out of the chest or abdomen? If YES,
STOP- DO NOT START CPR, Go to ADULT CPR SPECIAL
CONSIDERATIONS. If NO Put the HEEL of your
HAND on the CENTER of their CHEST between the
nipples. Put your OTHER HAND ON TOP of THAT
hand. PUSH DOWN on the HEELS of your hands, at
least 2 inches. Do it 30 times, PUSH HARD AND
FAST. Then, PINCH the NOSE SHUT and LIFT the
CHIN so the head BENDS BACK. LOOK IN THE MOUTH
FOR OBJECT,. If seen, remove it. Completely
cover their mouth with your mouth. Give TWO
BREATHS each lasting 1 second then PUMP the CHEST
30 times. KEEP DOING IT UNTIL HELP CAN TAKE
OVER or the patient starts breathing. IF
PATIENT STARTS BREATHING GO TO If an AED becomes
available go to
If there is more than one person present that is
willing to perform CPR have them switch with the
person doing CPR every 2 minutes.
UNCONCIOUS AIRWAY CONTROL
ENTRY POINT FROM ADULT CHOKING
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HAZMAT INCIDENT GUIDE
KEYQUESTIONS
Where is the emergency? Actual incident
location, direction of travel, best access if
applicable Are you in a safe location? If
YES continue questioning. If NO advise
caller to move to safe location and call
back. What happened? (Type of hazardous
material) Explosion, Odor Complaint, Fire, Air
release, Motor Vehicle Accident, Illegal dumping,
Leak / Spill, Abandoned container / materials,
Other. ?
Are there any injuries? IF YES
How many people are injured? What
is the nature of the injuries? Refer to
appropriate medical guidecard or local protocol
for MASS CASUALTY INCIDENT. What is the name
and/or ID of material? Use DOT Guidebook or
NLETS to obtain information about substance.
EMERGENCY MEDICAL DISPATCH
Hazardous Materials Agency
Dispatch
DISPATCH
Refer to the appropriate medical guidecard or
follow local protocol for Mass Casualty Incident.
Notify County and all applicable agencies
(NJDEP, Local and/or County OEM, etc.) per local
protocol.
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HAZMAT INCIDENT GUIDE Pre-Arrival Instructions
If you are not in a safe location, leave the area
and call back. Gather available chemical
information. Deny entry to affected area. Secure
premises, isolate area. Isolate injured from
scene if safely possible.
Prompts
Short Report
Amount spilled or released State of material
? Solid ? Liquid ? Gas Size / Type of
container Is the release continuous,
intermittent, or contained? Entering a waterway,
a storm drain or sewer? Have personnel been
evacuated? YES ? NO Are there any
emergency responders or HAZMAT trained personnel
on the scene? ? fire brigade ? security ?
other Is chemical information available for
responders? (I.e. MSDS, Hazardous
Substance Fact Sheet. IF YES Please have it
ready for the emergency responders. Wind
Direction ? N ? S ? E ?W (If not
available from caller, obtain from weather
service)
Incident location Access route Type of HazMat
incident Number and nature of injuries Release
type Wind direction
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VEHICLE IN WATER
State of New Jersey EMD Guidecards Version 01/12
KEYQUESTIONS
What kind of water are you in? River, lake or
flooded roadway Is the car sinking? Can you
open the vehicle doors? If NO Can you open the
vehicle windows? If NO go to Pre Arrival
Instructions
If the caller is a witness ask if they can relay
instructions to occupants of the vehicle. If so
go to Pre-Arrival Instructions
SIMULTANEOUS ALS/BLS
BLS
DISPATCH
DISPATCH
Vehicle in water sinking, submerged or stuck in
fast moving water.
Vehicle in still water, not sinking, water not
rising.
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VEHICLE IN WATER Pre-Arrival Instructions
Vehicle in still water Open vehicle doors or
windows, exit vehicle and wade to shore. If
unable to wade to shore Exit vehicle and go to
vehicle roof. Vehicle in water and
sinking Release your seatbelts and open the
windows. If your windows will not open, try to
break them. Hit the corner of the window with a
key, seat belt buckle or metal headrest post.
Exit through the window and get onto the roof of
the vehicle.
Vehicle is under the water If you are unable to
open a window there should be enough air for the
minute or two that it will take to prepare to
escape. When the car is nearly full of water,
take a deep breath and push a door open, you may
need to do this with your feet. Exhale slowly as
you swim to the surface.
Prompts
Short Report
If vehicle is sinking or in fast moving water
concentrate on getting the occupants out of the
vehicle and onto the roof. Once on the roof,
verify location. Consider need for boats, SCUBA
or Tactical/Rapid Water Rescue.
Specific locationNumber of occupants Any dangers
to responding units
40

GUIDELINES TO REQUEST AN ON-SCENE
HELICOPTER Air transportation should be
considered when emergency personnel have
evaluated the individual circumstances and found
any one of the following situations present.

• ENVIRONMENTAL FACTORS
• The time needed to transport a patient by ground
  to an appropriate facility poses a threat to the
  patients survival and recovery.
• Weather, road, and traffic conditions would
  seriously delay the patient's access to Advanced
  Life Support (ALS).
• Critical care personnel and equipment are needed
  to adequately care for the patient during
  transport.
• Falls of 20 feet or more.
• Motor vehicle crash (MVC) of 20 MPH or more
  without restraints.
• Rearward displacement of front of car by 20
  inches.
• Rearward displacement of front axle.
• Compartment intrusion, including roof gt12 inches
  occupant site gt18 inches any site.
• Ejection of patient from vehicle.
• Rollover.
• Deformity of a contact point (steering wheel,
  windshield, dashboard).
• Death of occupant in the same vehicle.
• Pedestrian struck at 20 MPH or more.

State of New Jersey EMD Guidecards Version 01/12

• INDICATORS OF SEVERE ANATOMIC OR
• PHYSIOLOGIC COMPROMISE
• Unconsciousness or decreasing level of
  consciousness.
• Systolic blood pressure less than 90 mmHg.
• Respiratory rate less than 10 per minute or
  greater than 29 per minute.
• Glasgow Coma Score less than 10.
• Compromised airway.
• Penetrating injury to chest, abdomen, head, neck,
  or groin.
• Two or more femur or humerus fractures.
• Flail chest.
• Amputation proximal to wrist or ankle.
• Paralysis or spinal cord injury.
• Severe burns.

1-800-332-4356 REMCS (Newark)